Integrate-Hta: A Low- And Middle-Income Country Perspective

Bijlmakers, Leon; Mueller, Debjani; Kahveci, Rabia; Chen, Yingyao; Wilt, Gert Jan van der

doi:10.1017/s0266462317000927

Cited by 12 publications

(15 citation statements)

References 20 publications

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“…In addition, the need for governments to prioritise their limited resources across disease areas ( Hatswell, 2020 ; Allen and Mirsaeidi, 2020 ), rather than devoting appreciable personnel and resources to one area to the detriment of others as seen currently with activities regarding COVID-19 ( Tables 2 , 2A , and 3 ). However, there are challenges including available personnel and resources as well as typically a greater focus on medicines among HTA units rather than other technologies ( Hernandez-Villafuerte et al., 2016 ; Bijlmakers et al., 2017 ; MacQuilkan et al., 2018 ; Fasseeh et al., 2020 ). This is changing with studies in Ghana evaluating the cost-benefit of moderate social distancing policies ( Ghana Prorities Project, 2020 ) and the cost-effectiveness of different prevention measures ( Asamoah et al, 2020) as well as groups in South Africa HTA evaluating the cost-effectiveness of ICU versus care on general wards with patients with severe COVID-19 ( SAMRC et al., 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Ogunleye

Basu

Mueller³

et al. 2020

Front. Pharmacol.

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176

215

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Background: The COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of other infectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa. Objective: Document current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups. Our Approach: Contextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel. Ongoing Activities: Prevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on Ogunleye et al. COVID-19 in Africa NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality. Conclusion: There are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other.

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Section: Resultsmentioning

confidence: 99%

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Ogunleye

Basu

Mueller³

et al. 2020

Front. Pharmacol.

Self Cite

176

215

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“…This stream is responsible for the formal introduction of HTA. Political factors may be a crucial determinant of HTA implementation and sustainability as observed in other low-and middle-income countries (LMICs) (18)(19)(20). Political will is required for HTA introduction, as observed in countries like India, Argentina, or Russia (5;6;19).…”

Section: Current Challengesmentioning

confidence: 99%

Addressing the challenges of implementing a Health Technology Assessment Policy Framework in South Africa

Mueller

2020

Int J Technol Assess Health Care

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Objective South Africa's commitment to progressively achieve universal health coverage can lead to the effective and appropriate use of Health Technology Assessment (HTA) to strengthen the healthcare system. The study aimed to analyze the challenges faced in the formal implementation and utilization of HTA in the public health sector. Methods Review and analysis of health technology policies and legislation introduced in South Africa since 1965 serves as the backbone of this study. Walt and Gilson's health policy triangle framework and Kingdon's model were used for data analysis. In addition, a semi-structured survey was conducted among key stakeholders, including those attending HTA workshops that were held in 2016 and 2017. Results The document review identified appropriate legislative and policy framework for informing healthcare decisions. Survey participants (n = 55) reported limited political support, local capacity, and awareness of HTA as barriers to implementing HTA. They noted that adequate financial resources and availability and sharing of quality data are primary drivers for HTA development. Effective governance, collaboration, and cooperation between key stakeholders of the healthcare system were suggested as possible ways forward for the institutionalization of HTA. Conclusion The South African government's goal to introduce the national health insurance program provides an excellent opportunity to formally introduce the use of HTA in decision making. Individual capacity development supported by institutional and organizational environments is urgently needed to achieve its full potential.

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“…Lastly, there are several approaches and toolkits available to support countries that are implementing HTA in their own setting even though they do not have the necessary infrastructure. For example, Bijlmakers et al suggest using the EU initiated framework of INTEGRATE framework for HTA for LMICs (32). Moreover, iDSI has proposed a toolkit to develop the process for HTA in countries (33).…”

Section: Discussionmentioning

confidence: 99%

From Design to Evaluation: Applications of Health Technology Assessment in Myanmar and Lessons for Low or Lower Middle-Income Countries

Dabak

Teerawattananon

Win

2019

Int J Technol Assess Health Care

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ObjectivesHealth technology assessment (HTA) has been widely used to inform coverage decisions in high-income countries over the past few decades and has been getting increasing attention in middle-income countries as a tool for healthcare decision making in recent years. This study aims to use the case of the Maternal and Child Health Voucher Scheme (MCHVS) in Myanmar to understand how HTA can have a policy impact in a low or lower middle-income country.MethodsThe stages heuristic framework was used to describe the policy-making process. A document review was conducted and tacit knowledge of researchers involved was recorded.ResultsThe opportunity for a grant propelled maternal and child health to the policy agenda. An ex-ante HTA, which included a model-based health economic evaluation, informed the design of the scheme. The framework and key parameters from the ex-ante HTA were used for a mid-term review, which provided feedback to the policy implementation process. An ex-post HTA involved fielding a household survey to assess the impact of the scheme.ConclusionsHTA can be a useful method for informing resource allocation throughout the policy process in low and lower middle-income settings where no formal mechanism for making coverage decisions exists.

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Integrate-Hta: A Low- And Middle-Income Country Perspective

Cited by 12 publications

References 20 publications

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Addressing the challenges of implementing a Health Technology Assessment Policy Framework in South Africa

From Design to Evaluation: Applications of Health Technology Assessment in Myanmar and Lessons for Low or Lower Middle-Income Countries

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